As advocates for women’s health–including leaders of pro-choice, faith-based, and health service delivery organizations–converge on Capitol Hill to ensure women’s basic health needs are included in health reform, two conservative Senators–Orrin Hatch (R-UT) and Ben Nelson (D-NE) are planning introduction of a “Stupak-like” amendment to the Senate bill.

The Coalition to Pass Health Care Reform and Stop Stupak!, a broad group of advocacy organizations including progressive groups, women’s health groups, organizations representing youth, communities of color, and people of faith and health professionals, has brought hundreds of advocates from throughout the country to meet with their members of Congress and stress that the Stupak amendment will take existing benefits away from women and jeopardize women’s health. The coalition is working to ensure that health care reform is passed and does not restrict women’s ability to purchase private health insurance that provides comprehensive reproductive health care, including abortion.

Speakers included Tiffany Campbell, a woman forced to decide between selective termination of one of a set of twins, or the loss of both twins to a rare medical condition. Tiffany told her story on Rewire here.

The DC Lobby Day is part of the coalition’s National Week of Action, November 30–December 6, to send a message to Congress that the anti-choice Stupak amendment must not be included in the final health care reform legislation.

Meanwhile, Nelson and Hatch are pushing to include exactly those amendments in the Senate bill. According to the original agreement on rules for debating the Senate bill, each side was to be allowed one amendment per day of debate. The Stupak amendment is a high priority for ultra-conservative forces inside the Senate, including Nelson and Hatch and could be introduced at any time.

According to Huffington Post, Nelson said Tuesday that “he won’t vote for health care reform unless the bill contains the same sort of restrictive abortion provisions as the House legislation.”

Would he vote for a final bill if he can’t get that language included? “No,” he told reporters.

“The conservative Nebraska Democrat has long been one of a handful of Senate holdouts on the issue of a government-run public health insurance option. This adds a new wrinkle,” writes Jeff Muskus of Huffington Post.

The Senate health care bill does not provide federal money for abortion, maintaining the status quo. But like Rep. Bart Stupak (D-Mich.) and a sizable bloc of conservative House Democrats, Nelson says that’s not good enough. Nelson said he plans to introduce an amendment to the Senate bill “exactly like” Stupak’s.

Women’s health and rights advocates oppose the Stupak amendment for a range of reasons, including that the amendment:

• Essentially violates the underlying principle of health care reform, as articulated by President Obama, that no one will lose the benefits the currently have.
• Under the Stupak amendment, millions of women would lose benefits that they currently have under private insurance and millions more would be prohibited from getting the kind of private sector health care coverage that most women have today even if they buy it with their own money.
• Women’s access to private coverage for abortion would be severely restricted by health care reform.

 

It is worth noting that there is no other legal medical procedure being targeted for exclusion within health reform (nor should any such procedures be so targeted), nor do individuals or groups get to exercise a “line-item veto” on the use of federal tax dollars based on belief or ideology for any other reason. People with moral or ethical objections to the Iraq war, to subsidies for the oil and gas industry or to industries emitting pollutants which can cause cancer and other illnesses don’t get a line-item veto on use of their tax dollars. Only legal, sound medical procedures essential to women’s health and human rights are being singled out.

Indeed ultra-conservatives are pushing for these amendments on the assumption that if they threaten to bring down health reform, they will get their way, thereby undermining access to health care for millions.

The new health insurance exchange to be created under current health reform bills is intended to provide a new source of affordable, quality coverage for the roughly 46 million uninsured Americans and the millions more whose current coverage is unaffordable or inadequate.

The House bill is expected to cover 96 percent of all uninsured Americans by offering subsidies for private coverage or the choice of a public plan. Depending on their income level and the final package approved by Congress, individuals would receive subsidies on a sliding scale to purchase private insurance through the exchange.

Not everyone in the exchange would have subsidized coverage — a significant portion of people (for instance, those currently purchasing in the individual market and those working for small businesses) who would buy insurance in the exchange would not receive any subsidies, also known as affordability credits.

The Stupak amendment prohibits any coverage of abortion in the public option and prohibits anyone receiving a federal subsidy from purchasing a health insurance plan that includes abortion.

It also prohibits private health insurance plans from offering through the exchange a plan that includes abortion coverage to both subsidized and unsubsidized individuals.

In other words, any 1 person receiving a federal subsidy out of 100 persons covered by a specific insurance plan would mean that that specific plan would be prohibited from providing insurance coverage for abortion care to any and all people it covered including those paying all insurance premiums with their own dollars.

The Stupak amendment purports to allow women to purchase a separate, single-service “abortion rider,” but abortion riders don’t exist. Moreover, women are unlikely to think ahead to choose a plan that includes abortion coverage, since they do not plan for unplanned pregnancy. Therefore in practice, the actual effect of the Stupak amendment is to ban abortion coverage across the entire exchange, for women with both subsidized and unsubsidized coverage.

Most immediately, the exchange would offer coverage to many of the 17 million women, 18–64, who are uninsured. It would also be a source of coverage for the 5.7 million women who are now purchasing coverage in the individual market.

In most of these cases, women will lose abortion coverage that they currently have — in the current private insurance market, the majority of health insurance plans include abortion.

Example: Currently, a self-employed graphic designer or writer, buying coverage from Kaiser Permanente in the individual market, likely has abortion coverage. Under the health reform plan amended by Stupak, she would purchase that same plan from Kaiser Permanente in the exchange, but it would not include abortion coverage because it would be barred. This ban would be in effect even if she were paying the full premium. Similarly, a woman working for a small graphic design firm, who currently has abortion coverage through her company’s plan, would lose it under reform if the company decides to seek more affordable coverage in the exchange.

Roughly 60 million women, 18–64, get their coverage through their employer or through their spouse’s employer. For some of these women, nothing will change immediately. But if current trends continue in the erosion of employer-sponsored health care, more and more women will be getting their health care through the exchange where abortion coverage is prohibited.